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General NPI Number Information
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NPI Number | 1699734095
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Entity Type | Individual
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Provider Name | DONALD WAYNE THOMAS PA
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Gender | Male
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Dates
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Enumeration Date | 03/23/2006
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Last Update Date | 02/06/2023
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Provider Practice Location Address
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Address Line | 11111 PANAMA CITY BEACH PKWY
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City | PANAMA CITY BEACH
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State | FL
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Zip | 32407-2448
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Country | US
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Telephone | 850-804-2900
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Fax |
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Provider Business Mailing Address
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Address Line | 602 SECOND ST
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City | DESTIN
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State | FL
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Zip | 32541-1604
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Country | US
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Telephone | 615-351-5320
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | PA9111311
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | PA0000001124
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License Number State | TN
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